原发免疫性血小板减少症患者血清整合素相关蛋白47和可溶性程序性死亡受体-配体1水平及临床价值  

Expression and clinical value of integrin-associated protein 47 and soluble programmed death-ligand 1 in patients with primary immune thrombocytopenia

作　　者：李岩[1] 许静静[1] 张玉芹[1] 侯滨 常洪劲[1] Li Yan;Xu Jingjing;Zhang Yuqin;Hou Bin;Chang Hongjin(Department of Blood Transfusion,Affiliated Hospital of Jining Medical University,Jining 272000,China;Department of Clinical Laboratory,the Second People′s Hospital of Jining,Jining 272049,China)

机构地区：[1]济宁医学院附属医院输血科,济宁272000 [2]济宁市第二人民医院检验科,济宁272049

出　　处：《中国医师进修杂志》2025年第2期168-172,共5页Chinese Journal of Postgraduates of Medicine

基　　金：济宁市重点研发计划(2022YXNS038)。

摘　　要：目的探讨原发免疫性血小板减少症(ITP)患者血清整合素相关蛋白47(CD47)和可溶性程序性死亡受体-配体1(sPD-L1)水平变化及临床价值。方法回顾性选取2016年7月至2022年7月济宁医学院附属医院收治的76例ITP患者作为研究组,另选取76例同期进行体检的健康体检者作为对照组。采用酶联免疫吸附法测定两组血清CD47、sPD-L1、白细胞介素33(IL-33)及转化生长因子-β(TGF-β)水平,采用受试者工作特征(ROC)曲线分析CD47和sPD-L1对ITP的诊断价值,采用Pearson检验分析ITP患者血清CD47和sPD-L1的相关性,采用多因素Logistic回归分析ITP的危险因素。结果研究组血清CD47、sPD-L1、IL-33水平高于对照组[(40.31±6.59)μg/L比(32.16±6.33)μg/L、(78.42±10.22)ng/L比(64.49±10.36)ng/L、(73.29±14.26)ng/L比(26.54±5.16)ng/L],TGF-β水平低于对照组[(1752.66±310.73)ng/L比(2625.88±389.58)ng/L],差异均有统计学意义(P<0.05)。Pearson检验结果表明,ITP患者血清CD47和sPD-L1水平呈正相关(r=0.572,P<0.05)。ROC曲线分析结果显示,血清CD47和sPD-L1联合诊断ITP的曲线下面积为0.948(95%CI 0.916~0.979),优于CD47、sPD-L1单独诊断(P<0.05)。Logistic回归分析结果显示,CD47、sPD-L1、IL-33是影响ITP发生的危险因素(P<0.05),TGF-β是影响ITP发生的保护因素(P<0.05)。结论ITP患者血清CD47和sPD-L1水平升高,二者联合检测对ITP具有良好的诊断价值。Objective To investigate the expression and clinical value of integrin-associated protein 47(CD47)and soluble programmed death receptor-ligand 1(sPD-L1)in patients with primary immune thrombocytopenia(ITP).Methods The method of retrospective study was adopted,76 patients with ITP admitted to the Affiliated Hospital of Jining Medical University from July 2016 to July 2022 were regarded as the study group,and another 76 cases of physical examination were regarded as the control group.The levels of serum CD47,sPD-L1,interleukin-33(IL-33)and transforming growth factor beta(TGF-β)were determined by the enzyme-linked immunosorbent assay,the diagnostic value of CD47 and sPD-L1 for ITP was analyzed by the receiver operating characteristic(ROC)curve,Pearson test was applied to analyze the correlation between serum CD47 and sPD-L1 in ITP patients,multivariate Logistic regression analysis was applied to analyze the risk factors affecting ITP.Results The levels of serum CD47,sPD-L1 and IL-33 in the study group were higher than those in the control group:(40.31±6.59)μg/L vs.(32.16±6.33)μg/L,(78.42±10.22)ng/L vs.(64.49±10.36)ng/L,(73.29±14.26)ng/L vs.(26.54±5.16)ng/L;the level of serum TGF-βin the study group was lower than that in the control group:(1752.66±310.73)ng/L vs.(2625.88±389.58)ng/L,there were statistical differences(P<0.05).The result of the Pearson test showed that there was a positive correlation between serum CD47 and sPD-L1 in ITP patients(r=0.572,P<0.05).The result of the ROC curve showed that the area under the curve predicted by the combination of serum CD47 and sPD-L1 was 0.948(95%CI 0.916-0.979),which was better than that predicted by CD47 and sPD-L1 alone(P<0.05).The result of multivariate Logistic regression analysis showed that CD47,sPD-L1,and IL-33 were the risk factors affecting ITP(P<0.05),and TGF-βwas the protective factor affecting ITP(P<0.05).Conclusions The serum levels of CD47 and sPD-L1 in patients with ITP are elevated,and the combined detection of the two indicators has a good di

关 键 词：原发免疫性血小板减少症 整合素相关蛋白47 可溶性程序性死亡受体-配体1 白细胞介素33 转化生长因子-Β 

分 类 号：R558.2[医药卫生—血液循环系统疾病]